Online Treatment Services – working with clients in rural and remote areasAustralian Winter School 2013

Ray Stephens – Online Project Leader

“The community services system needs to be focused on digital technology opportunities and prepared for the changes and challenges it will bring”.

(Shergold, 2013)

The future is here

Current climate

• Pressures on health funding• NBN, ehealth, telemedicine,

smartphones, increasing use of internet for health and health information

• = focus on technology to increase access, timeliness, reduce costs

“Long anticipated change is occurring in healthcare and organisations need to understand how information technology can help them respond successfully to this coming challenge.” Emediawire.com 2013-05-29

Current climate

Initiatives that are currently being utilised in the alcohol and drug sector include:

• Counselling online – text based counselling running for some years now (Turning Point and others)

• Social Media – particularly in youth services such as reachout, YSAS, dancewize, dreams up in smoke

• Self-help courses such as Say When and online screening

• Groups or forums such as Sibling Support • Telehealth?

An estimated 1.8 million patients will be treated through telehealth worldwide by 2017.

Telehealth

“80% of what doctors do today will be replaced by technology in 10 years.”

Vinod Khosla - Sun Microsystems co founder, 2013

TelehealthPortable kiosks

“Digital Health feels like the PC industry in the early ’80 s.”′

John Sculley – Former CEO of Apple and PepsiCo – Digital Health Summit, January 2012

One more thing…..

"Accelerating the use of innovative technologies across the world can benefit all countries. eHealth and mHealth can help the previously helpless share in the benefits of an improved social environment.“

Archbishop Desmond Tutu – Chairman, Global eHealth Ambassadors Programme, April 2013

Remote barriers

• < 18 y.o. male• Youth outreach worker fortnightly• Requires inpatient youth detox• Lives in Corryong

Accessing detox 1

• Wodonga via bus• 1 bus (1.5 hrs) each way / day

• Assessment withdrawal nurse• Phone assessment Williams House• Back to Corryong• Full day out• 3 week waiting list• 2nd daily phone contact with Wodonga

Accessing detox 2

• Bed comes up• Bus to Wodonga (1.5 hours)

• Meet withdrawal nurse

• Melbourne via train (4 hours)• Cab to hotel• Overnight in hotel• Next day cab to Williams House

Completed withdrawal program

Cost

3 bus trips Albury to Corryong $ 93

Train to Melbourne $ 32

Cab to hotel $ 20

Hotel$ 80

Cab to Williams House$ 10

Total$235

To get to resi-withdrawal

Cost

Cab to city $ 20

Train Melbourne to Wodonga $ 32

Cab to hotel$ 10

Hotel$ 80

Bus Albury to Corryong $ 31

Total$173

Total travel cost = $408

To get to home

Gaps

Cost of transport

Time in travelling

Separation from family

Multiple workers involved

= engagement?

Accessing detox

• Wodonga via bus• 1 bus (1.5 hrs) each way / day• Assessment withdrawal nurse

• Phone assessment Williams House• Back to Corryong• Full day out• 3 week waiting list

• 2nd daily phone contact with Wodonga

• Video assessment

Videoconferencing Project

• 2 year trial• Using videoconferencing for remote assessments• Access to Williams House Youth Resi Withdrawal• Statewide catchment

Videoconferencing Project - Aims

• Reduce travel time – staff, client, family• Reduce costs • Improved assessments, timely responses• Demystify• Engagement• Collaboration

Videoconferencing Project - Cost

• ~ $15K setup• Free to partners• Can be done for free (or a webcam)

Videoconferencing Project - Progress

• Conducting assessments with 2 rural agencies• Positive client experiences• Positive staff experiences• “It has confirmed that we have opened a new door

for allowing access to remote clients to our service and reducing barriers.”

Videoconferencing Project - Learnings

• Tech issues• Needs to be integrated• Change is slow – training and lots of support• Staff will find other uses

Activity

Online treatment

5 years from now what might you be doing?

• With clients• Within your organisation• With other organisations

Activity 2

• Barriers?• Can we break these down?

Activity 3

• Short – term • In pairs come up with one initiative you can

implement at your service• Present this back

Activity 4

Change management• How do we move our organisations / sector

towards online treatment

Resources

http://www.scoop.it/t/telehealth-ehealth-videoconferencing

rstephens@regen.org.au